Health-related concerns of people who receive psychological support for inflammatory bowel disease.
BACKGROUND
People with inflammatory bowel disease (IBD) cope with a number of disease-specific concerns, which may result in referrals for supportive counselling.


OBJECTIVE
To determine differences between the health-related concerns of people with IBD who seek counselling or are referred for psychiatric assessment and those who have no recent contact with counselling or psychiatry.


METHODS
Forty-five consecutive patients with IBD referred for psychiatric consultation and 31 IBD out-patients who had recent counselling were compared with 190 IBD out-patients at the same hospital with no recent history of counselling. Disease-related concerns, demographic data and perceived symptom severity were assessed with self-report instruments.


RESULTS
Counselling patients had greater overall intensity of concern. Counselling patients differed from noncounselling patients on several measures related to illness severity and were more likely to be female. Correcting statistically for illness severity and sex, the counselled patients had significantly higher levels of concern about being a burden, pain and suffering, feeling out of control, financial difficulties, feeling alone, sexual performance, feeling dirty or smelly and being treated as different.


CONCLUSIONS
Beyond the intensity of their physical suffering, patients who seek counselling report a pattern of concern in which interpersonal and emotional concerns are prominent compared with those of out-patients who do not seek counselling. Clinicians should be aware of interpersonal concerns, which may increase the need for empathic support. Psychosocial interventions in IBD may be indicated without respect to psychiatric comorbidity.
Maunder
R G
RG
Department of Psychiatry, Mount Sinai Hospital, Toronto, Ontario. bmaunder@interlog.com
de Rooy
E C
EC
Toner
B B
BB
Greenberg
G R
GR
Steinhart
A H
AH
McLeod
R S
RS
Cohen
Z
Z
D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D003376:Counseling; D003710:Demography; D004644:Emotions; D004645:Empathy; D005260:Female; D005376:Financial Management; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology / Q000523:psychology*; D007389:Internal-External Control; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012649:Self Concept; D012647:Self-Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D012725:Sexual Behavior; D012803:Sick Role